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Maintain a copy of this document in your files. Submit one copy to the Local Enforcement Agency. <br /> I hereby certify that all body art practitioners performing body art at this facility and <br /> employees or individuals involved with decontamination and sterilization procedures have <br /> been trained with the procedures and information contained in this document and to the best <br /> of my knowledge and belief, the statements made herein are correct and true. <br /> Signature: Date: <br /> Page 7 of 10 <br />